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Prior Authorization Form

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Prior Authorization Form

National Mobility Equipment Dealers Association Political Action Committee, Inc. Prior Authorization Form

Before an individual in the "restricted class" can be asked to contribute to National Mobility Equipment Dealer’s Association Political Action Committee, Inc., his or her company's National Mobility Equipment Dealers Association (NMEDA) primary contact must have completed an National Mobility Equipment Dealers Association Political Action Committee, Inc. Prior Authorization Form. The primary contact is defined as the representatives of the corporation with whom the trade association normally conducts the association's activities. At times, this may be the Vice President or Director of Business Relations not a company’s President or Owner. In the middle of the form, you will notice the statement: “The company may not approve a solicitation by any other trade association for these years.” Federal election law states that a corporate member company of a trade association can only give prior authorization to one trade association PAC per year. By signing this form, you are verifying that you are an authorized representative for your company and that National Mobility Equipment Dealers Association is the only trade association which your company has given prior authorization to for the same calendar year(s) indicated.

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Name*
Address*
Select Years for Authorization*
Please check the appropriate boxes to authorize National Mobility Equipment Dealer’s Association Political Action Committee, Inc. to solicit voluntary contributions from you and or the executive and administrative personnel of your company. You may authorize your company for the next twelve years.